Jan 2, 2011 9:24 AM

I have been experiencing heart palpitations during runs recently. I have pretty low mileage--maybe 15-20 miles/week. I have mild mitral valve prolapse and have been cleared by my doctor to exercise, but I must admit these make me kind of nervous. Are there any fellow runners out there with any knowledge or experience with this??

MVP is nothing to mess with, but you did say "mild." Your doctor cleared you to exercise, but was running the specific exercise in mind?

Two things I would recommend in any case, are some assessment of mineral imbalances (sodium, potassium, calcium, etc) and possibly vitamin deficiencies (absorption is more important than intake - many pills go in one end and out the other).

There is also a musculo-skeletal interaction with chest pain known as upper Sternalis Syndrome, involving the thin muscle over your Sternum, or "breast bone" that is the boney plate extending from the base of the front of your neck to the center of the ribs. Is pain involved, and could there be a feedback loop from the anxiety it produces? If so, you may need some coaching to get it under control. My bet is it will disappear over time.

Here is a discussion of Chest Wall Syndrome as an alternative explanation for pain (and associated problems) in case that is a component of the problem...

I was diagnosed with a heart murmur, and always wear a heart monitor when I run. I recently acquired an inexpensive data recorder so I can graph my heart rate over a workout. I've found wilder swings in heart rate during colder weather, sometimes way over my theoretical max, as recently as a few weeks ago. This is more likely to occur at the beginning of a run. At times I've heard my heart pounding in my ears, even during slow or medium intensity runs. In that case, it is more likely to occur later in a longer run. I am happy to report, however, that in a recent marathon (2 weeks ago) I very quickly reached my target rate of 155 and it hardly varied at all during the entire event. There may be some interaction with how well you are focused on the workout vs. your condition. Just a thought.

For grins, here's a graph of a marathon (the plateau, with dips for long sips of gatorade), followed by eating, walking, driving, climbing steps to pack, and driving some more. The uptick at the end is when I spotted Nike and Adidas stores at an outlet mall off the highway, lol. Being able to look at this stuff gives me confidence, which ultimately may be the most important part of all.

The high heart rate recordings early in your runs are likely to be because the HRM isn't getting the required electrical conductivity with your skin. On a dry and cold day my HR will sometimes record at well over 200, which is pretty much impossible at my age. Then, after a mile or so it always drops down to something more normal, likely because I start sweating more. Using some inexpensive conductive gel apparently fixes the problem. However, since I don't have a heart problem I can just ignore the first mile and save a few dollars per year on gel.

Thanks Chuntley for reminding me about the moisture thing. I've been good about using my monitor, but bad about keeping it wet.

I actually have a 2oz tube of Spectra 360 on my desk at work, which I never use professionally because all our electrode patches are solid gel/adhesive combo. Some people just spit on the chest straps before use (which Polar even recommends), but the more fluid the substance, the sooner it evaporates or reacts with the skin. Not to mention enzyme activity that might lead to irritation on longer runs. Spectra claims to be salt-free, and I suppose that would be technically correct if they use other electrolytes (these companies guard their formulas). Before my marathon I moistened my skin with some of my Electromix drink, which is just salt-free electrolytes and a little stevia. Then I used some aloe gel before fastening the strap. I suppose by gun time I had already developed a little perspiration during all the commotion, but I needed the confidence because I don't get to track lengthy competitions very often.

From what I have read, heart rates can be a bit out of range in the early parts of a run anyway, until the body adjusts to the activity. That's one reason for a good warm-up, but with respect to the original poster, I think our attention to HR might seem a little obsessive, even though for us it may be healthy. One thing I mined from the study I linked is the possible effect of psychosomatic feedback on anxiety, which could manifest as an irregular heart rate, especially the more focus it gets. That's one reason I record the rate now rather than watching it in real time. With the confidence that no detail will escape me, I set the range alarm for safety and look at the data later. Prior to that, I noticed that when I kept looking at the readout while running, the rate would go up a couple ticks the more I fretted about it. I like Galloway's marathon suggestion to forget about the numbers and other left-brain stuff, and enjoy the run. It was his observation that we last longer running by feel, as long as we don't forget to stage our comfort levels properly, ie., we should stay comfortable early on through about half-way and make our push after the legs know what they've gotten themselves into.

Here's an example of a bad read on a crisp morning you were talking about:

Clearly there was something wrong there, because I felt my Carotid to make sure, and it was nowhere near that high. I've also had interference problems using headset cords when carrying a cell phone. Although the original poster did not mention monitors, but a history of palpitations, that could be judged by feel, but a little knowledge in that case could be just as dangerous as not knowing at all. Better safe than sorry, I suppose, as long as our technology is really working and does not overwhelm our self-confidence. One very experienced runner I knew ran into heart arrhythmias and was counciled by his doctor to stop running for a while. The culprit was apparently his crappy diet from fast food chains (won't mention names, but you know who they are), which he got under control with great results. His doctor mentioned a potassium deficiency that may have been caused by his high sodium diet, which would lead to loss of other vital electrolytes as his body attempted to rid itself of the excess sodium through sweat and urine. Because of heavy water intake, sweating and increased appetites for junk food, runners especially should be on the lookout for mineral imbalances that can have a profound effect on the heart. This is even true in winter when the sweat often evaporates too quickly for us to notice.

I have MVP, been on meds for it for twenty-mumble years and I still get the occasional stumble in the chest, though it rarely happens when I'm physically exerting myself. If it's getting to be troublesome, you should probably talk to your doctor about whether your meds need adjusting.

Lyndsie, have you done an internet search for this? I did because I will occasionally have palpitations just sitting that are very disconcerting, and have on occasion had them when running. Based on the information I found, you should get checked out for this but in most cases it ends up being a non-issue. In some people they are seen more as activity increases. In my case there doesn't seem to be a steady pattern to when it happens.

I would recommend you be checked by a doctor, perhaps even have a stress test to see if this is exercise induced, and whether it is a medical issue for concern. Do not ignore it, because if it is a symptom of a bigger problem, getting that diagnosed and treated is the next best step for you healthwise.

C25k dropout

Rock the Parkway 5k 3/27/10 37:40.6

Mother's Day 5k 5/9/10 33:19

Walk/Run for Isaiah 9/18/10 4.4k 37:26

Harvest Moon 10k 10/23/10 1:08.50

Great Santa 5k 12/5/10 33:22

Carlsbad half marathon 1/23/11

"Look deep into nature, and then you will understand everything better." ~Albert Einstein

I seriously doubt my HR was in the 220 range for that first mile, especially since it was just the warmup. It just took that long for the reading to get accurate enough to matter. As I said, if I had a MVP condition or something like that then I suppose I'd care to get a better reading. Sorry if I distracted from the main thread ...

Thanks for the responses!!! I will definitely check in with my doctor about this. I should probably start using my heart monitor again and try to keep my HR in target range. I have had problems with it working properly though. Nan, it is nice to know there are other runners with MVP out there!!

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